Sequoia Project Healthcare Directory Implementation Guide
1.18.0 - Release 1

Extension: InitiatorOnly - JSON Profile

Active as of 2026-10-27

JSON representation of the InitiatorOnly extension.

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{
  "resourceType" : "StructureDefinition",
  "id" : "InitiatorOnly",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: StructureDefinition InitiatorOnly</b></p><a name=\"InitiatorOnly\"> </a><a name=\"hcInitiatorOnly\"> </a><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" class=\"xhtTableBorder0\"><tr class=\"xhtRowBorder1\"><th scope=\"col\" style=\"\" class=\"hierarchy xhtCellBorder0\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"The logical name of the element\">Name</a></th><th scope=\"col\" style=\"\" class=\"hierarchy xhtCellBorder0\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Information about the use of the element\">Flags</a></th><th scope=\"col\" style=\"\" class=\"hierarchy xhtCellBorder0\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Minimum and Maximum # of times the element can appear in the instance\">Card.</a></th><th scope=\"col\" style=\"; width: 100px\" class=\"hierarchy xhtCellBorder0\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Reference to the type of the element\">Type</a></th><th scope=\"col\" style=\"\" class=\"hierarchy xhtCellBorder0\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Additional information about the element\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr class=\"xhtRowBorder0 xhtRowEven\"><td style=\"background-image: url(tbl_bck1.png)\" class=\"hierarchy xhtCellBorder0 xhtCellNoWrap\"><img src=\"tbl_spacer.png\" alt=\"\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-InitiatorOnly-definitions.html#Extension\">Extension</a><a name=\"Extension\"> </a></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"/><td style=\"\" class=\"hierarchy xhtCellBorder0\"><span class=\"xhtPieceDeEmphasized\">0</span><span class=\"xhtPieceDeEmphasized\">..</span><span class=\"xhtPieceDeEmphasized\">*</span></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"><a href=\"http://hl7.org/fhir/R4/extensibility.html#Extension\">Extension</a></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"><span class=\"xhtPieceDeEmphasized\">Extension</span></td></tr>\r\n<tr class=\"xhtRowBorder0 xhtRowOdd\"><td style=\"background-image: url(tbl_bck10.png)\" class=\"hierarchy xhtCellBorder0 xhtCellNoWrap\"><img src=\"tbl_spacer.png\" alt=\"\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\"\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_extension_simple.png\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Simple Extension\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">Extension.</span><a href=\"StructureDefinition-InitiatorOnly-definitions.html#Extension.extension\" class=\"xhtPieceStrikeout\">extension</a><a name=\"Extension.extension\"> </a></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"/><td style=\"\" class=\"hierarchy xhtCellBorder0\"><span class=\"xhtPieceStrikeout\"/><span class=\"xhtPieceStrikeout xhtPieceDeEmphasized\">0</span><span class=\"xhtPieceStrikeout\">..</span><span class=\"xhtPieceStrikeout\">0</span></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"/><td style=\"\" class=\"hierarchy xhtCellBorder0\"><span class=\"xhtPieceItalic xhtPieceDeEmphasized\">Extension</span></td></tr>\r\n<tr class=\"xhtRowBorder0 xhtRowEven\"><td style=\"background-image: url(tbl_bck10.png)\" class=\"hierarchy xhtCellBorder0 xhtCellNoWrap\"><img src=\"tbl_spacer.png\" alt=\"\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\"\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\"\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">Extension.</span><a href=\"StructureDefinition-InitiatorOnly-definitions.html#Extension.url\">url</a><a name=\"Extension.url\"> </a></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"/><td style=\"\" class=\"hierarchy xhtCellBorder0\"><span class=\"xhtPieceDeEmphasized\">1</span><span class=\"xhtPieceDeEmphasized\">..</span><span class=\"xhtPieceDeEmphasized\">1</span></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\" class=\"xhtPieceDeEmphasized\">uri</a></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"><span class=\"xhtPieceDarkGreen\">&quot;https://sequoiaproject.org/fhir/sphd/StructureDefinition/InitiatorOnly&quot;</span></td></tr>\r\n<tr class=\"xhtRowBorder0 xhtRowOdd\"><td style=\"background-image: url(tbl_bck00.png)\" class=\"hierarchy xhtCellBorder0 xhtCellNoWrap\"><img src=\"tbl_spacer.png\" alt=\"\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\"\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\"\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <span style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0\" class=\"sr-only\">Extension.</span><a href=\"StructureDefinition-InitiatorOnly-definitions.html#Extension.value[x]\">value[x]</a><a name=\"Extension.value_x_\"> </a></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"/><td style=\"\" class=\"hierarchy xhtCellBorder0\">1..<span class=\"xhtPieceDeEmphasized\">1</span></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"\" class=\"hierarchy xhtCellBorder0\"><span class=\"xhtPieceDeEmphasized\">Value of extension</span><br class=\"binding\"/><span class=\"xhtPieceBold binding\">Binding: </span><a href=\"ValueSet-InitiatorOnly.html\" title=\"https://sequoiaproject.org/fhir/sphd/ValueSet/InitiatorOnly\" class=\"binding\">Initiator Only</a><span class=\"binding\"> (</span><a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\" class=\"binding\">required</a><span class=\"binding\">)</span></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
  },
  "url" : "https://sequoiaproject.org/fhir/sphd/StructureDefinition/InitiatorOnly",
  "version" : "1.18.0",
  "name" : "InitiatorOnly",
  "title" : "Initiator Only",
  "status" : "active",
  "date" : "2026-10-27T16:14:23-04:00",
  "publisher" : "The Sequoia Project",
  "contact" : [
    {
      "name" : "The Sequoia Project",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://sequoiaproject.org/"
        }
      ]
    }
  ],
  "description" : "When an Organization participates in a Use Case that includes a requirement to respond to requests from others, this extension may be used on that Organization resource to indicate that they meet an Initiator Only exception and do not have Endpoints for that Use Case, if allowed by the Use Case's Initiator Only policies.",
  "fhirVersion" : "4.0.1",
  "mapping" : [
    {
      "identity" : "rim",
      "uri" : "http://hl7.org/v3",
      "name" : "RIM Mapping"
    }
  ],
  "kind" : "complex-type",
  "abstract" : false,
  "context" : [
    {
      "type" : "element",
      "expression" : "Organization"
    }
  ],
  "type" : "Extension",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Extension",
  "derivation" : "constraint",
  "snapshot" : {
    "extension" : [
      {
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
        "valueString" : "4.0.1"
      }
    ],
    "element" : [
      {
        "id" : "Extension",
        "path" : "Extension",
        "short" : "Extension",
        "definition" : "An Extension",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Extension",
          "min" : 0,
          "max" : "*"
        },
        "condition" : [
          "ele-1"
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
            "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier" : false
      },
      {
        "id" : "Extension.id",
        "path" : "Extension.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "Unique id for inter-element referencing",
        "definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl" : "string"
              }
            ],
            "code" : "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Extension.extension",
        "path" : "Extension.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "description" : "Extensions are always sliced by (at least) url",
          "rules" : "open"
        },
        "short" : "Extension",
        "definition" : "An Extension",
        "min" : 0,
        "max" : "0",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Extension.url",
        "path" : "Extension.url",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "identifies the meaning of the extension",
        "definition" : "Source of the definition for the extension code - a logical name or a URL.",
        "comment" : "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "Extension.url",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl" : "uri"
              }
            ],
            "code" : "http://hl7.org/fhirpath/System.String"
          }
        ],
        "fixedUri" : "https://sequoiaproject.org/fhir/sphd/StructureDefinition/InitiatorOnly",
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Extension.value[x]",
        "path" : "Extension.value[x]",
        "short" : "Value of extension",
        "definition" : "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "Extension.value[x]",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Coding"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "binding" : {
          "strength" : "required",
          "valueSet" : "https://sequoiaproject.org/fhir/sphd/ValueSet/InitiatorOnly"
        },
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      }
    ]
  },
  "differential" : {
    "element" : [
      {
        "id" : "Extension",
        "path" : "Extension"
      },
      {
        "id" : "Extension.extension",
        "path" : "Extension.extension",
        "max" : "0"
      },
      {
        "id" : "Extension.url",
        "path" : "Extension.url",
        "fixedUri" : "https://sequoiaproject.org/fhir/sphd/StructureDefinition/InitiatorOnly"
      },
      {
        "id" : "Extension.value[x]",
        "path" : "Extension.value[x]",
        "min" : 1,
        "type" : [
          {
            "code" : "Coding"
          }
        ],
        "binding" : {
          "strength" : "required",
          "valueSet" : "https://sequoiaproject.org/fhir/sphd/ValueSet/InitiatorOnly"
        }
      }
    ]
  }
}